Chemical sphincterotomy by topical nitroglycerin for treatment of chronic anal fissure, an alternative to lateral sphincterotomy

ABSTRACT

Chronic anal fissure is a common and painful condition associated with internal anal sphincter hypertonia. Reduction of this hypertonia improves the local blood supply, encouraging fissure healing. Surgical sphincterotomy is very successful at healing these fissures but requires an operation with associated morbidity. Temporary reduction in sphincter tone can be achieved on an outpatient basis by applying a topical nitric oxide donour [for example, glyceryl trinitrate]